Paterson Inquiry

Debate between Baroness Blackwood of North Oxford and Lord Hunt of Kings Heath

Tuesday 4th February 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank my noble friend for that question, and for his important contribution. He is of course very experienced in this area. Obviously we are looking for time in the legislative agenda to bring forward HSSIB. It is appropriate that we consider the patient safety elements of this report’s recommendations in the context of that Bill. In the previous Second Reading debate, which we look forward to repeating, we discussed the issues around the independent sector. But we will also separately, and perhaps in conjunction with that, consult on the key changes necessary to enable data on admitted patient care to be transferred from the Private Healthcare Information Network and independent providers directly to NHS Digital, which should start to take us in the direction of closing the gap, which I know that many noble Lords in the House are rightly concerned about.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I declare an interest as a board member of the GMC. I also chaired the Heart of England Foundation Trust from 2011 to 2014. Mr Paterson worked for the trust as well as in the private sector hospital that the Minister mentioned. I would like to add my personal apology to that of the Minister to the patients and families for the suffering that they endured. Mr Paterson was suspended shortly after I became chairman and we instituted Sir Ian Kennedy’s review. We now have a second inquiry and I pay tribute to Bishop Graham for his work. I have only had the chance to read the Statement quickly, but it seems a thorough piece of work and has many far-reaching lessons and recommendations for the health service.

I have a couple of suggestions for the Minister. First, one of the recommendations is around the way that regulators work together, or not. At the moment, legislation is rather out of date and sometimes gets in the way of collaborative working, although one should never use that as an excuse. As part of the legislative review, I wondered whether the need for reform of the whole regulatory system will be kept closely under review.

Secondly, I want to follow the Minister on this issue of NHS bodies being reluctant to own up to things that have gone wrong because of the potential legal liability. I have discussed this with bodies at the national level and they all say that that is nonsense and organisations should not fear apologising, but it is heavily in the culture of the NHS not to apologise because of potential liability. As part of the consideration of these recommendations, I suggest that the Government seriously look at giving an explicit statement to the NHS on the facts of this and encourage those working in the NHS always to be open about things that have gone wrong.

[Baroness Blackwood of North Oxford]

I thank the noble Lord for that important and knowledgeable contribution. His point about the sharing of lessons between regulators was well made. Part of the reason for proposing HSSIB is for systemic learning of lessons that might otherwise not be available because an inquiry might happen in one trust or group of trusts and lessons might not transfer across the entire system. The whole principle of HSSIB is cross-system learning. We already have evidence that that is working.

Furthermore, the principles at the heart of the patient safety agenda that my right honourable friend Jeremy Hunt put in place were to embed a culture of learning and not blame within the NHS so that apologies can be forthcoming. We have some way to go in achieving that change of culture, but the noble Lord is quite right that leadership starts from the top and having the right statements is a good start. The principles around the place of safety, the protection of whistleblowers and allowing people to come forward and say when they think that things are going wrong without fear of retribution are steps in the right direction. The right action after that is transparency and the recommendations in this report about transparency lead to the right actions being taken from that point.

NHS: A&E Waiting Time Target

Debate between Baroness Blackwood of North Oxford and Lord Hunt of Kings Heath

Tuesday 21st January 2020 Lords Chamber

[Lord Hunt of Kings Heath]

To ask Her Majesty’s Government what plans they have, if any, to change the four hour accident and emergency waiting time target.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, the existing standard is still in place. NHS England and NHS Improvement are reviewing access standards in four key areas, including urgent and emergency care. The Government will respond to recommendations from the review once it is concluded.

[Lord Hunt of Kings Heath (Lab)]

My Lords, in December, for 68.6% of patients the four-hour target was met, against the actual target of 95%. That is the worst month ever. The Government’s response, behind the warm words of the Minister today, is that they want to get rid of the target, yet research published last week by Cornell and the IFS shows that the current target saves at least 15,000 lives a year. The Royal College of Emergency Medicine has said that there is no viable alternative to the current target. The college says that the Government should get on with getting this target back on track. Will the Government do that?

[Baroness Blackwood of North Oxford]

The noble Lord always asks astute questions. Winter is a challenging time. Over 2 million people attended A&E last month, and we have to pay tribute to the dedicated NHS staff for seeing over 70,000 people every day—the highest number in December ever. Although we have more NHS beds open this winter than last, our A&Es have had to treat more people. The A&E waiting standard is being looked at by clinicians, who are considering whether it is appropriate, given the changes that have occurred in clinical standards. The five key reasons considered for moving away from the standard include: the standard does not measure total waiting times; the standard does not differentiate between the severity of conditions; the current standard measures a single point in an often very complex patient pathway; and there is evidence that processes, rather than clinical judgment, are resulting in admission or discharge in the period immediately before a patient breaches the standard, which is a perverse incentive. The Government will not do anything without public consultation and clinical recommendation. We will wait to see that, and no decision will be made until that comes forward.

Health: Vaping

Debate between Baroness Blackwood of North Oxford and Lord Hunt of Kings Heath

Tuesday 14th January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

The Government have consistently highlighted that quitting smoking and nicotine use completely is the best way to improve health. Although they are not risk free, research shows that e-cigarettes are effective in helping smokers to quit. That is why we committed in the long-term plan to roll out “stop smoking” services in the NHS, to support improvements even on our smoking cessation rates—smoking is now at its lowest level on record, down from 18.4% in 2013 to 14.4%.

[Lord Hunt of Kings Heath (Lab)]

My Lords, does the noble Baroness agree that, looking back over the past 10 or 20 years, apart from the ban on smoking in public places, vaping has been the most successful intervention to reduce smoking? Does she therefore agree that we need to be cautious before we rush into trying to ban or overregulate its use, as some campaigners want?

[Baroness Blackwood of North Oxford]

As I said, more than 50,000 additional people quit smoking through e-cigarette use each year. We see e-cigarettes as an effective and safer route to quitting smoking than other routes. However, we understand that, at the moment, there is no evidence on the impact of long-term vaping, which is why Public Health England continues to update and publish the evidence base on e-cigarettes annually. We will continue to monitor the impacts of that use.

NHS: Nurses

Debate between Baroness Blackwood of North Oxford and Lord Hunt of Kings Heath

Tuesday 7th January 2020 Lords Chamber

[Lord Hunt of Kings Heath]

To ask Her Majesty’s Government when they expect to meet the Conservative party manifesto commitment to deliver 50,000 more nurses in the National Health Service.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, we expect to increase nurse numbers by 50,000 by 2025. Eligible preregistration students on courses at English universities from September 2020 will receive additional support of at least £5,000 a year, which they will not need to repay. Additional payments of up to £3,000 will be available for some students in regions or specialisms struggling to recruit and to help students to cover childcare costs. We encourage everyone considering this incredible career to apply before the deadline on 15 January.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I am grateful to the Minister, but the manifesto pledge and what she said today seem to me to have a whiff of fantasy, due to double counting, uncertain finances and a less than precise timetable. Of the 50,000 extra nurses, it turns out that only 30,500 will actually be additional nurses, of whom 12,500 will have to be recruited from other countries. Of the 18,500 that the Government are so magically going to persuade to stay on against the current trends, 12,400 were already pledged in the NHS plan published earlier in the year. It all seems to be on a bit of a wing and a prayer as to whether the Government will get anywhere near a net increase of 50,000. How can the Minister be confident that they are going to succeed when the student nurse attrition rate is at 25% and 14,000 qualified applicants were turned away from nurse courses last year?

[Baroness Blackwood of North Oxford]

My Lords, first, I thank the NHS staff who have worked so hard over the Christmas and new year period. I point the noble Lord to the recent record; the NHS now has over 20,300 more nurses on our wards than in 2010 and over 52,000 more nurses in training. We have increased our training places by 25% since September 2018 and made available 3,000 more midwifery places to ensure that we can achieve this outcome. We have put in place several actions on recruitment and retention, because we need to retain our extremely experienced and excellent nurses and to recruit more nurses to support them. That is why we have announced this new package, which will not only increase nurse payment by 12% but provide support for those in training, attracting more nurses in to support those already in place.